High ethionamide resistance in mycobacterium tuberculosis strains isolated in Kenya.

Ongaya V.A, Githui W.A, Meme H, Kiiyukia C, Juma E.


Ongaya V.A[1, 2, 3], Githui W.A[1], Meme H[1], Kiiyukia C[2], Juma E[1]

  1. Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI).
  2. Jomo Kenyatta university of Agriculture and Technology (JKUAT).
  3. Mount Kenya University.

SUMMARY

Background: Increasing development of tuberculosis (TB) resistance to the currently available drugs including second-line anti-TB drugs that are being used for treatment of Multi-Drug Resistant TB (MDR-TB) patients has frustrated efforts to control TB worldwide. Ethionamide (Eth) is one of the drugs used in the regimen for treatment of these patients.
Objective: To determine level of Ethionamide resistance among second-line anti-tuberculosis drugs in Mycobacterium tuberculosis (MTB) strains isolated in Kenya.
Design: A retrospective lab-based study involving archived strains from previous studies carried out at the Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI) from 2002 to 2007.
Setting: Centre for Respiratory Diseases Research (CRDR), Kenya Medical Research Institute (KEMRI).
Methods: A total of 216 MTB strains with pre-determined first-line drug susceptibility testing (DST) results were used including 78 first-line resistant to individual and combined drugs, and 138 susceptible to streptomycin, rifampicin, isoniazid and ethambutol. The strains were subjected to DST to ethionamide among other second-line.
Results: Thirty two [32/216 (14.8%)] strains showed resistance to second-line drugs. Resistance to Eth was the highest [18/32 (56.3%)] including co-resistance with isoniazid [8/18 (44.4%)]. Nine [9/18 (50%)] strains were fully resistant and 9 [9/18 (50%)] were intermediate resistant to Eth.
Conclusion: Unexplainable high levels of Eth resistance is a cause for concern. This will impact negatively on the outcome of management of MDR-TB especially in Kenya where the use of this drug is almost mandatory. Close monitoring of Eth before initiating individual patient management may be necessary.
Key words: Ethionamide, Resistant, MDR-TB.

[Afr J Health Sci. 2012; 20:37-41]

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